A more novel and robust gene signature predicts outcome in patients with esophageal squamous cell carcinoma

BackgroundEsophageal squamous cell carcinoma (ESCC) is a life-threatening thoracic tumor with a poor prognosis. The tumor microenvironment (TME) mainly comprises tumor cells and tumor-infiltrating immune cells mixed with stromal components. The latest research has displayed that tumor immune cell infiltration (ICI) is closely connected with the ESCC patients' clinical prognosis. This study was designed to construct a gene signature based on the ICI of ESCC to predict prognosis.MethodsBased on the selection criteria we set, the eligible ESCC cases from the GSE53625 and TCGA-ESCA datasets were chosen for the training cohort and the validation cohort, respectively. Unsupervised clustering detailed grouped ESCC cases of the training cohort based on the ICI profile. We determined the differential expression genes (DEGs) between the ICI clusters, and, subsequently, we adopted the univariate Cox analysis to recognize DEGs with prognostic potential. These screened DEGs underwent a Lasso regression, which then generated a gene signature. The harvested signature's predictive ability was further examined by the Kaplan-Meier analysis, Cox analysis, ROC, IAUC, and IBS. More importantly, we listed similar studies in the most recent year and compared theirs with ours. We performed the functional annotation, immune relevant signature correlation analysis, and immune infiltrating analysis to thoroughly understand the functional mechanism of the signature and the immune cells’ roles in the gene signature's predicting capacity.ResultsA sixteen-gene signature (ARSD, BCAT1, BIK, CLDN11, DLEU7-AS1, GGH, IGFBP2, LINC01037, LINC01446, LINC01497, M1AP, PCSK2, PCSK5, PPP2R2A, TIGD7, and TMSB4X) was generated from the Lasso model. We then confirmed the signature as having solid and stable prognostic capacity by several statistical methods. We revealed the superiority of our signature after comparing it to our predecessors, and the GSEA uncovered the specifically mechanism of action related to the gene signature. Two immune relevant signatures, including GZMA and LAG3 were identified associating with our signature. The immune-infiltrating analysis identified crucial roles of resting mast cells, which potentially support the sixteen-gene signature's prognosis ability.ConclusionsWe discovered a robust sixteen-gene signature that can accurately predict ESCC prognosis. The immune relevant signatures, GZMA and LAG3, and resting mast cells infiltrating were closely linked to the sixteen-gene signature's ability.     

胃镜下无表现但伴肝脏炎性浸润的巨大胃间质瘤

病例报告患者，女，55岁，以“上腹部轻微不适8d”为主诉入院。8d前无原因出现上腹部轻微不适，偶有腹胀、恶心，无呕吐、发热，无周身乏力、体重减轻情况，于我院门诊行CT检查发现肝左叶外侧段外侧见团块样软组织密度影，内部密度不均，中心密度较低，CT值为30HU，病灶内可见半环形略高密度影，CT值为56HU。增强扫描病灶中心部位逐渐强化，病灶最大截面约4．6cm×5．8cm，     

改良喉部分切除术治疗声门型喉癌的疗效分析

目的 探讨保留甲状软骨的喉部分切除术在治疗声门型喉癌中的可行性及其手术效果.方法 回顾性分析1999年1月至2009年1月收治的声门型喉癌患者128例,术中肉眼和病理证实甲状软骨内膜无癌细胞侵犯或甲状软骨局灶性破坏无需大范围切除的T2-3期病例,采用病例对照研究方法,按部位相同、TNM分期相同,年龄相差≤10岁,1∶1配对.研究组为保留甲状软骨的喉部分切除术患者,共64例,其中T2N038例,T2N16例,T2N21例,T3N0 17例,T3N12例;对照组为传统喉部分切除术患者,共64例,TNM分期同研究组.比较两组患者生存率、局部控制率和总拔管率.结果 研究组3年及5年累积生存率分别为89.8％,84.3％,对照组分别为91.5％,85.4％,两组比较差异无统计学意义（x2=1.687,P＞0.05）;研究组局部控制率为91.7％（55/60）,对照组为93.2％（55/59）,两组比较差异无统计学意义（x2=0.103,P＞ 0.05）;研究组总拔管率为98.3％（59/60）,对照组为89.8％（53/59）,两组比较差异有统计学意义（x2=4.933,P＜ 0.05）.结论 对于T2期和部分T3期声门型喉癌患者的治疗,与传统喉部分切除术式相比,保留甲状软骨的喉部分切除术在保证彻底切除肿瘤、保留足够安全缘的同时,保留了喉功能,其术后拔管率高,并发症发生率低,有助于改善喉癌患者术后的生活质量.     

Correlation Between Blood Lipid Levels and Chronic Pancreatitis: A Retrospective Case–Control Study of 48 Cases

The incidence of chronic pancreatitis (CP) is increasing, and dyslipidemia severely affects the health of middle-aged and elderly people. We investigated the association between blood lipid levels and CP.The serum lipid metabolic indices of 48 patients with CP (CP group) were summarized retrospectively. The physical examination results of 40 randomly selected healthy individuals were used as the normal control (NC) group. Statistical analyses of the blood lipid data were performed between the 2 groups using the case–control study method.High-density lipoprotein-cholesterol (HDL-c) levels decreased and fasting blood glucose (GLU) levels increased in the CP group compared with those in the NC group (P < 0.01). Pearson correlation analysis results showed that serum amylase (AMY) was positively correlated with low-density lipoprotein-cholesterol (LDL-c; r = 0.414, P < 0.05), and urine AMY (UAMY) was positively correlated with total cholesterol (TC; r = 0.614, P < 0.01) and LDL-c (r = 0.678, P < 0.01). A binary logistic regression analysis showed that GLU (odds ratio [OR], 5.052; P < 0.01) and TC (OR, 1.074; P < 0.01) may be risk factors for CP, whereas HDL-c may be a CP protective factor (OR, 0.833; P < 0.01).The HDL-c levels decreased and GLU levels increased in the CP group compared with those in the NC group; AMY was positively correlated with LDL-c and UAMY was positively correlated with TC and LDL-c; GLU and TC may be risk factors for CP; and HDL-c may be a CP protective factor. This may be the first time that such results have been reported. These findings will contribute to primary prevention and control of CP progression.     

以突眼为表现的眼部血管病——颈动脉海绵窦瘘的介入治疗

目的探讨颈动脉海绵窦瘘眼部表现特点、影像学检查及介入治疗方法。 方法回顾分析5年中18例首诊于我院眼科的颈动脉海绵窦瘘者的眼部症状及体征、影像学检查、治疗方法等。18例患者均行介入手术治疗,其中应用可解脱球囊封堵瘘口12例,应用弹簧圈+Onyx胶封堵瘘口3例,覆膜支架隔绝瘘口3例。 结果所有病例中最常见的眼部表现为搏动性眼球突出、球结膜充血水肿、眼球运动障碍等。头颅或眼部CT平扫检查所有病例均显示患侧眼球突出,眼上静脉增粗;全部患者均行数字减影血管造影检查明确诊断。本组18例（20眼）均行介入手术治疗,其中应用可解脱球囊封堵瘘口12例（14眼）,结果10例（12眼）瘘口完全闭塞,发生并发症2例,无严重并发症或死亡病例。应用弹簧圈+Onyx胶封堵瘘口3例（3眼）、覆膜支架隔绝瘘口3例（3眼）,瘘口均完全闭塞,无并发症或死亡病例。全部手术患者眼部症状和体征均得到明显改善。随访时间（12±3.4）个月,无复发病例,颈动脉覆膜支架内未发生狭窄及闭塞。 结论对于以突眼及其他相关症状就诊于眼科的患者,应考虑颈动脉海绵窦瘘的可能,血管造影是该病诊断的金标准,介入手术治疗对颈动脉海绵窦瘘是安全有效的。     

原发性外阴阴道恶性黑色素瘤16例临床分析

目的探讨原发性外阴阴道恶性黑色素瘤的临床特点、治疗及预后。方法回顾性分析大连医科大学附属第一医院自1995年6月～2010年2月期间收治的16例外阴阴道恶黑的临床资料：结果本组16例病例中,外阴恶黑12例（75．00％）,阴道恶黑4例（25．00％）。手术率81．00％,手术方式以外阴广泛切除术和局部扩大切除术为主,8例患者应用了辅助治疗方法（免疫治疗、放疗、化疗）。随访时间1～98个月,失访2例,随访率87．50％,随访期内因复发或转移死亡9例,死亡率56．70％。外阴恶黑患者平均生存期37．10个月,3年生存率（除外失访和生存不足3年患者）为55．50％,仅3例患者现无瘤生存;阴道恶黑患者中1例生存期为17个月,2例现带瘤平均生存34．00个月,1例失访。结论原发性外阴阴道恶黑恶性程度高,治疗应以手术为主,辅以免疫、放化疗,早期诊断、合理分期、早期治疗、定期随诊是改善预后的关键因素。     

扩散峰度成像定量参数直方图分析鉴别子宫癌肉瘤与变性子宫肌瘤的价值

目的:探讨扩散峰度成像(DKI)定量参数直方图分析鉴别子宫癌肉瘤(UCS)和变性子宫肌瘤(DH)的价值。方法:回顾性分析经手术病理证实的11例UCS和22例DH患者的资料。患者均行盆腔DKI扫描,经后处理获得DKI定量参数,包括平均弥散峰度(MK)、平均弥散系数(MD)、各向异性分数(FA),后采用Omni-Kinetics软件进行直方图分析,获得DKI各参数的中位数、平均值、标准差、偏度、峰度、25%位数、75%位数、能量、熵等直方图参数。采用独立样本t检验(正态分布)或Mann-Whitney秩和检验(偏态分布)比较UCS和DH的各直方图参数的差异,采用ROC曲线评价有统计学差异的直方图参数对UCS和DH的鉴别效能。结果:两组间MK的标准差、75%位数、熵,MD的中位数、平均值、25%位数、75%位数,FA的中位数、平均值、标准差、25%位数、75%位数、能量、熵的差异具有统计学意义(P均<0.05);两组间MK的中位数、平均值、偏度、峰度、25%位数、能量,MD的标准差、偏度、峰度、能量、熵,FA的偏度、峰度的差异无统计学意义(P均>0.05);FA的中位数、75%位数的曲线ROC下面积最大(均为0.921);FA的75%位数的敏感度最高(100.0%);MK的标准差的特异度最高(100.0%)。结论:DKI定量参数直方图分析有助于鉴别UCS与DH。